New evidence identified on safety of IVF embryo screening method

Researchers at the University of Kent have identified crucial new evidence on the safety and efficacy of a controversial area of IVF treatment – preimplantation genetic testing for aneuploidy (PGT-A).

PGT-A is the screening for gross genetic (chromosomal) abnormalities in human IVF embryos with a view to improving IVF success rates and guarding against miscarriage. The UK Human Fertilisation and Embryology Authority’s (HFEA) however recently assigned it a “red light” in terms of its safety and efficacy. The current study provides strong evidence for the benefits of PGT-A.
The, researchers used the HFEA’s own 2016-2018 data to examine live birth and other outcomes reported, with and without PGT-A. Statistical analysis of differences between PGT-A and “regular” IVF cycles was performed, grouping by maternal age, the leading known risk factor for chromosome abnormalities.

Data was gathered for nearly 2,500 PGT-A, out of a total of over 190,000 cycles in total. Live Birth Rate per embryo transferred and per treatment cycle was significantly higher for all PGT-A vs regular IVF age groups. In patients aged over 40, the reported live birth rates were 3-11 times greater when using PGT-A compared to regular IVF alone.
There was also a reduced number of transfers per live birth, particularly for women aged over 40, implying patients became pregnant faster if PGT-A was used.
Though the study identified strong evidence-based benefits of PGT-A, it is limited in matching with complete clinical indication information, PGT-A and non PGT-A cohorts.

PGT-A is a controversial process in IVF. Proponents argue that evidence suggests this treatment is effective and safe. Opponents argue that, until randomised clinical trials establish this unequivocally, patients should not be subjected to it; especially as this is a paid-for treatment.
On the basis of a traffic light system designed to assess the suitability of adjunct treatments for IVF, the HFEA previously assigned the process two Red Lights as a treatment whose efficacy and safety had not been established. This was recently changed to one red light.

Darren Griffin, Professor of Genetics at Kent and Lead Author on the paper said: ‘This data will hopefully aid the HFEA in their continual surveillance of the “Red traffic light” guidance that currently states there is no evidence that PGT-A is effective or safe. The guidance could be revised in the light of this new data for patient benefit. I appreciate the collegial way in which the HFEA have assisted in providing this data and their open-mindedness to the prospect of revisiting their guidance and traffic light system.’

Source: Obs Gynae &Midwifery News


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Chemicals in sunscreen may cause infertility

A new study from the National Institutes of Health finds that chemicals in sunscreens and personal care products that filter out UV rays may lead to infertility issues among men.

According to the study by the National Institutes of Health and the New York state Department of Health’s Wadsworth Center, researchers found that men with high exposure to UV filters BP-2 or 4OH-BP had a 30 percent reduction in fecundity, the biological ability to reproduce. Lower fecundity may result in a longer time to pregnancy.

The researchers studied 501 couples that were trying to conceive a child from 16 counties in Michigan and Texas in 2005 through 2009. The women participants ranged from 18 to 44 years of age, and the men were over 18; none had a medical diagnosis of infertility.

Male infertility tools: FISH analysis and DNA fragmentation test

ART (Assisted Reproductive Technologies) advances have now provided couples with accurate genetic screening tests like FISH analysis and DNA fragmentation test, as diagnostic tools for male infertility aiding them in improving theirs chances of pregnancy.

Infertility is not primarily a woman’s problem, as it is mistakenly believed. It is estimated that infertility for about half of couples is due to a male factor, either alone or in addition to female factors. So, if a couple suffers from infertility problems men should also be evaluated for infertility.

FISH analysis and DNA fragmentation test

FISH analysis and DNA fragmentation tests are diagnostic tools for male infertility

However, the routinely used in IVF clinics semen analysis testing appears to be inadequate in diagnosing the male factor infertility. In many cases couples dealing with conception problems have given a basic semen analysis testing result that is normal in terms of sperm concentration, motility and morphology. Yet the problem remains. In such cases genetic screening tests that can detect genetic abnormalities can be of great help, comprising diagnostic tools of great clinical value.

DNA fragmentation test is a genetic test that according to fertility doctors is associated with every fertility checkpoint and in contrast to conventional semen analysis it can discriminate between the sperm of fertile and infertile men. This test could explain the reason why you are not parents yet as high levels of DNA fragmentation can inhibit a successful pregnancy despite the type of fertility treatment provided. High levels of damaged DNA have been correlated to a series of things like infections, smoking, and exposure to environmental toxic chemicals.

Another quite useful genetic test given in IVF clinics is FISH (Fluorescent In Situ Hybridisation). FISH analysis is a genetic test screening for genetic abnormalities providing information about the sperm chromosomes. It consists of sperm chromosome-specific DNA probes labeled with fluorochromes. FISH is an advanced technique that can now facilitate evaluation of sperm aneuploidy.

Both, FISH analysis and DNA fragmentation tests are diagnostic tools for male infertility that can support a specialized diagnose of male factor especially for couples who have experienced repeated IVF failures and pregnancy loss.

If male factor infertility is the source of your trouble would you advise your doctor on proper genetic testing for improving your pregnancy chances?


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Pesticides may increase risk of endometriosis

Pesticides may increase the risk of endometriosis research study warns. Study findings warn about the environmental effects on the health of women of reproductive age.

Research conducted at the Fred Hutchinson Cancer Research Center revealed that two organochlorine pesticides are linked to endometriosis in women of reproductive age. Researchers collected data from two study groups: a group of 248 women diagnosed with endometriosis, and a second control group of 538 healthy women. All women were of reproductive age among 18 and 40 year old.

The study found that women who were exposed at greater level at such pesticides (beta-hexachlorocyclohexane, mirex) were 30-70% more likely to suffer from endometriosis. These results, suggesting that pesticides may increase risk of endometriosis, were published in Environmental Health Perspectives, a journal of the National Institute of Environmental Health Sciences.

pesticides endometriosis

Environmental chemicals used in the past could impact the reproductive health of future generations

The PhD scientist who led the study, Victoria Holt, originally thought of investigating pesticides effects on female reproductive health as it has been previously shown that organochlorine pesticides can have estrogenic properties, mimicking the effects of estrogens (reproductive hormones). It is also known that endometriosis is an estrogen dependent disease so it would make sense if such chemicals negatively affect the female reproductive system is some way.

Endometriosis is the pathogenic condition where the womb tissue lining grows outside of the womb and attaches to other organs. It is a painful, chronic condition and because of that thousands of women visit fertility clinics for treatments.

Nowadays, it is estimated that the number of women diagnosed with the disease has greatly increased since 1940 with millions of women over the globe affected, making them struggle with infertility problems as well.

Since endometriosis is the effect of hormonal imbalances it is quite possible that pesticides do exactly that. In animal studies, organochlorine pesticides have been found to alter the uterus and ovaries function as well as causing hormonal imbalances.

According to lead author of the study, Kristen Upson, the surprising fact about the results is that these pesticides were detected in the blood of the women, increasing the risk of endometriosis, while being banned in the U.S. “the message here is that environmental chemicals used in the past could  impact the reproductive health of future generations” she commented.

Are you aware of ways to avoid pesticides in your diet and protect your fertility?


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Endometriosis as a cause of infertility

Endometriosis is a common pathogenic condition of women that, in the past, it has been associated with infertility. But is endometriosis a cause of infertility? Quite often women diagnosed with infertility happen to be diagnosed endometriosis with as well. Scientists ponder however whether there is indeed a link between the disease and infertility or endometriosis is a coincidental discovery made during the examination for infertility.

woman-endometriosis

Endometriosis is a painful, chronic condition.

Endometriosis is the pathogenic condition where the womb tissue lining grows outside of the womb and attaches to other organs. It is a painful, chronic condition and because of that thousands of women visit fertility clinics for treatments. Nowadays, it is estimated that the number of women diagnosed with the disease has greatly increased since 1940 with millions of women affected worldwide. A higher prevalence of the disease is found among women with infertility.

But, endometriosis, is it a cause of infertility itself? According to a new study, the answer tends to be negative. As the main author of the study, Stacey Missmer – director of Epidemiologic Research in Reproductive Medicine at Brigham and Women’s hospital, reported most of women diagnosed with endometriosis do not have fertility problems and they are able to achieve pregnancy. She added however that women with the disease have increased chances for suffering from infertility compared to healthy women.

For the study, published in Human Reproduction, the researchers analyzed data from 58,427 women in order to establish the association of endometriosis with infertility incidents. One of the study findings was that only women aged <35 with endometriosis are at a greater risk of infertility.

Surprisingly, it was found that previous estimates of infertility incidents in women with endometriosis were overestimated in terms of numbers probably due to studies’ artifacts. More specifically, researchers reported that the infertility risk linked to endometriosis is approximately 50% lower compared to other studies’ results.

The major need now for fertility specialists is to further investigate this relationship between the disease and infertility and to become able to identify the specific group of women with endometriosis who are in greater risk for infertility in order to be treated properly and in time.

If you’re facing infertility,have you been tested for endometriosis?


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Cinnamon: a fertile spice

Did you know that cinnamon apart from sweet and tasty is also a ‘’fertile’’ spice? It is pretty much known that cinnamon has many health benefits but now new research suggests that its properties make cinnamon a great ally for infertility problems.

cinnamon

If you are suffering from PCOS it might worth to give cinnamon a chance.

One of the most common causes of infertility in women is PCOS (polycystic ovary syndrome). It affects approximately 5-10% of women of reproductive age and it can cause ovary cysts, acne, body and facial hair overgrowth, obesity, severe menstrual irregularities and as a consequence infertility.

Quite often, women with PCOS are found to have elevated insulin levels causing them insulin resistance and therefore are more likely to develop diabetes. However, elevated insulin levels do not only increase blood sugar levels but they can also differentiate reproductive hormones’ levels, crucial for ovulation and menstrual cycle.

Many women with PCOS who struggle to get pregnant once they have their insulin levels regulated, they do see an improvement of their fertility. According to a research from the University of Columbia, it appears that daily cinnamon consumption can aid in menstrual cycle regulation for women with PCOS.

45 women with PCOS took part in the study and they were split in two groups. Half of them received natural cinnamon supplements twice a day while the other half received a placebo tablet with no cinnamon. After six months, women who consumed cinnamon daily had over 4 menstrual cycles more in average compared to the placebo group. Furthermore, 2 women of the cinnamon group achieved pregnancy during the actual study adding to the belief that cinnamon may work as a fertility booster.

So, if you are suffering from PCOS it might worth to give cinnamon a chance. Even though during this small clinical trial the optimal cinnamon dose was not investigated, it was only shown that it works, you could advise your doctor on the matter and the possibility to add a daily dose of the spice to your nutrition. For the study women consumed 1500 mg of cinnamon per day so this amount might be enough for improving your fertility as well.

So far, it is not known whether more women, other than those diagnosed with PCOS, could benefit from cinnamon in terms of fertility but there is surely no harm in trying it!

So, how about spicing up your life a bit with a dash of cinnamon?


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Natural Ways for Enhancing Fertility

1 in 8 couples worldwide have trouble getting pregnant. If you are one of them

Yoga and meditation can boost fertility

Yoga and meditation are two popular stress reduction practices among people, with possible positive and natural way for enhancing fertility

you might want to try some natural ways for enhancing fertility, before you turn to complex fertility treatments; avoiding costly fertility drugs, injections and all these disturbing procedures involved in typical medical treatments, is enough of a reason for many couples.

There are several folk customs applying to different cultures about enhancing fertility, more or less weird. Chunky fertility statues, special dances, spells and even…cute hitting with sacrificed goat skin in ancient Roman fertility celebrations.

Well you don’t need to go this far, there are simpler more natural ways for enhancing your fertility and here are a few suggestions:

Get some sleep: Sleep deprivation induces a decrease of leptin hormone levels. This decrease causes the brain to suspend the less fundamental functions of the body like ovulation, causing irregular periods and infertility.

Just relax! The more stressed a woman is the harder it is for her to conceive. If typical exercise is not your cup of tea, there are a number of alternative ways for reducing stress levels and perhaps improving your fertility chances. Yoga and meditation are two popular stress reduction practices among people, with possible positive effects on pregnancy chances.

In 2012, approximately 21 and 17 million adults practiced yoga and meditation respectively in USA. According to researchers, couples who took part in a program incorporating yoga, meditation, emotional support and diet changes had a 50% fertility rate within one year. This study was based on the ongoing programs at the mind-body Institute at Harvard University.

Apricots and orange fruits: An old custom in China wants the bride to be to consume fresh apricots for enhancing fertility, since the mineral content of the fruit promotes sexual hormone production. As for men, researchers of the University of West Australia showed that orange colored fruits (β-Carotene) with antioxidant properties like apricots, melons, mangoes and carrots, as well as vitamin E-rich foods, could help them maintain their sperm healthy.

Ankle massage: According to reflexology, ankles are sensitive parts of our body with many nerve fiber endings that correspond directly to the most erogenous body zones. The outside of the ankles, specifically, is the most vital area for reproductive health so massage of these spots enhances fertility.

Would you consider such options for enhancing your fertility?


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IVF Is Not Always Your Best Option

IVF Is Not Always Your Best Option

IVF is not always the best option for infertility treatment and it is highly recommended for patients to go through a thorough investigation in order to have a clear idea about why they need IVF.

Professor Robert Winston, one of the founding fathers of IVF, has recently published his new book, The Essential Fertility Guide, in which he outlines

fertility treatment options suggesting that IVF is not always your best option for infertility treatment.

For many people, there is no other experience that matches the birth of a baby. One in every seven couples in the UK struggle with infertility. There are various reasons for this and a number of treatments available for optimizing their chances of having a baby.

However, there is also a lot of misinformation out there about infertility treatment, so experts say people should be careful about which advice they heed.  Especially in the private sector where expensive IVF, which only has a 25 percent success rate, is a highly profitable industry.  The fact that a large number of patients address to private clinics for solving their infertility problems could perhaps explain why many people assume the best option for overcoming infertility is IVF (in vitro fertilisation), which according to Professor Winston is often not the case.

When patients meet with their doctor they are often surprised to learn that IVF may not be their first treatment option for infertility. In reality, IVF technique is used far too often before other, usually cheaper and less stressful options, are fully explored. For that reason, it is highly recommended for patients to go through a thorough investigation in order to find out the exact cause of their infertility and have a clear idea about why they need IVF. Prof. Winston adds that most of the infertile couples do not require such a complex treatment and often expectant treatment, ie. waiting to get pregnant, is likely to be more effective than IVF.

It is advisable for infertile patients to start with low tech treatments. Starting with the simplest, most affordable treatment options first and move up to more advanced treatments as medically indicated, is the best way to deal with it.”There are numerous causes of infertility,” says Prof. Winston, “and the best treatment may be different in each circumstance.

Intrauterine insemination (IUI) is an example of a low tech treatment frequently requiring less medication and fewer monitoring appointments with a lower cost. Depending on the cause, other alternatives to IVF could be drug treatments to encourage ovulation, laparoscopic (minimally invasive) surgery or treatment for endometriosis.

Have you asked the right questions to your doctor?

Make sure you are properly tested to identify the cause of infertility and choose the best treatment option for you.


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Breast Cancer and Fertility Options

Breast cancer is not common in young women. Less than 5% of all breast cancers diagnosed in the U.S. occur in women under 40. However breast cancer

Breast cancer

The main concern for young women being treated for breast cancer is their fertility options.

in younger women is usually more aggressive and is more likely for them to require chemotherapy. A breast cancer diagnosis can be very shocking for young women since usually at that time in life creating a family is a top priority, so it is really important to them to have fertility options.

The main concern for young women being treated for breast cancer is loss of fertility. Even though breast cancer itself does not impact fertility since it does not damage the ovaries and general reproductive health what impairs or threatens to impair fertility is the treatment of it. More specifically, the two major ways of treating breast cancer that can cause infertility are the chemotherapy and the endocrine therapy.

Standard cytotoxic chemotherapy for breast cancer can damage the ovaries and most of the regimens used for breast cancer seem to cause ovarian toxicity to some level. The level of fertility damage depends on the amount of therapy given and the specific regimen, as well as the age of the woman at diagnosis.

The other major factor is the time it takes to receive appropriate endocrine therapy. Hormonal therapies (tamoxifen, ovarian suppression) are usually given for a period of 5 to 10 years. During that time it’s not that the woman’s reproductive system is damaged by the drugs but it is modified or suppressed in the short term, not permanently. The problem with that is while women are on these drugs their ovaries still aging in time as they naturally do in women growing older.

Breast Cancer and Fertility Options

Two are the main ways to preserve the fertility and increase the chance of having children later:

  1. Cryopreservation, the process of freezing and storing embryos or oocytes for later use. After ovarian stimulation fertility specialists will get oocytes and get them fertilized in a test tube—classic IVF. The embryos can be implanted in the womb after full treatment recovery. The other option is to freeze the oocytes for later use, a method that has now proved out quite successful.
  2. Ovary suppression, a method that spares the reproductive system. This approach uses drugs called gonadotropin-releasing hormone (GnRH) analogs that can suppress the ovarian function through treatment and temporarily shut down the body’s production of eggs. This process seems to protect the cells that develop into eggs from damage during breast cancer treatment.

Those are the main options and there are more experimental things on the way, including taking a piece of the ovary and freezing that. There is a lot of research going into that so it is likely that more fertility options will come up in the future for women treated for breast cancer.

Would you discuss your options with a fertility specialist before making treatment decisions?


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Human sperm in vitro created by scientists

Human sperm cells have been successfully created in the laboratory for the first time by using an artificial bioreactor. This is a breakthrough in infertility treatment sought for more than a decade since no one had been able to complete the complicated process of sperm maturation in vitro.

human sperm by scientists

Human sperm cells have been successfully created in the laboratory

Researchers based at a French national research institute in Lyon had announced this discovery previously, but they and government lab CNRS explained the process for the first time on Sept. 17 after taking out a patent on it.

Scientists have managed to complete spermatogenesis in vitro, a process taking place in the male testes in vivo, which leads the immature germ cells to become mature spermatozoa fully competent to fertilize. They succeeded this by developing a bioreactor using a viscous fluid, made partly of substances found in the walls of mushrooms, to mimic the in vivo conditions.

Scientists claim that this achievement promises to succeed in helping young men with cancer that caused them fertility issues later in their lives and adult men who cannot make their own sperm. About 15,000 men are made sterile due to cancer treatments and other 120,000 suffer from untreatable infertility. They explained that their fertility could be preserved by developing mature human sperm from their immature cells, then freezing it. The team hopes to be able to treat patients as soon as 4 years.

Even though trials have been reportedly successful on rat, monkey and human sperm cells, the lack of further details on the process has other scientists feeling skeptical. They look forward to the publication of the study so that to be able to discuss details of the research with the team and reveal the full mechanism through which such a process was accomplished in vitro.

Is this novel data or what?


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